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What is a pressure sore?
A pressure sore is any redness or break in the skin caused by too much pressure on your skin for too long a period of time. The pressure prevents blood from getting to your skin so the skin dies. Normally the nerves send messages of pain or feelings of discomfort to your brain to let you know that you need to change position, but damage to your spinal cord keeps these messages from reaching your brain.
You may need to learn new ways to change your position to prevent too much pressure. Pressure sores can occur, for example, when you sit or lie in one position too long. Shearing is also a kind of pressure injury. It happens when the skin moves one way and the bone underneath it moves another way. An example of this is if you slouch when you sit.
Another type of injury, an abrasion, can occur when pulling yourself across a surface instead of lifting. This is an example of a friction injury. In addition, short exposure to high pressure, such as a bump or fall, may cause damage to the skin which may not show up right away.
Stages of pressure sores and how to care for them: (see disclaimer)
STAGE ONE:
How to recognize: Skin is not broken but is red or discolored. The redness or change in color does not fade within 30 minutes after pressure is removed.
What to do:
Keep pressure off the sore! Maintain good hygiene. Wash with mild soap and water, rinse well, pat dry carefully (but gently). Do not rub vigorously directly over the wound. Evaluate your diet -- are you getting enough protein, calories, vitamins A and C, zinc and iron? All of these are necessary for healthy skin. Review your mattress, wheelchair cushion, transfers, pressure releases, and turning techniques for possible cause of the problem. If the sore seems to be caused by friction, sometimes a protective transparent dressing such as Op-Site or Tegaderm may help protect the area by allowing the skin to slide easily. If the sore does not heal in a few days or recurs, consult your health care provider.
STAGE TWO:
How to recognize: The epidermis or topmost layer of the skin is broken, creating a shallow open sore. Drainage may or may not be present.
What to do: Follow steps 1-4 under stage 1 Consult your health care provider for further treatment which may include the following:
Cleanse the wound with saline solution only and dry carefully. Apply either a transparent dressing (such as Op-Site or Tegaderm), a hydrocolloid dressing (such as DuoDERM), or saline dampened gauze. The first two types of dressing can be left on until they wrinkle or loosen (up to 5 days). If using gauze, it should be changed twice a day and should remain damp between dressing changes. Check for signs of wound healing with each dressing change. If there are signs of infection, consult your health care provider immediately for alternative wound care ideas and review of possible causes.
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